Definitions
HIPAA: These are the 4 instances where disclosure of personal health information is justified.
What are:
1. Necessary for treatment
2. Necessary to obtain or provide reimbursement or payment for services
3. For policy and assessment activities such as quality assurance, outcomes evaluations
4. Legally permissible when disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public
A 42-year-old male patient tells you he recently tested positive for an STI but asks you not to record it in his medical chart because his wife has access to his online portal. Later, his wife calls the clinic requesting an update on his recent test results.
As his provider, what should you do to uphold patient confidentiality while remaining ethically and legally compliant?
What is refuse to share any medical information with his wife without the patient’s consent and accurately document the diagnosis in the chart.
True or False: All states have the same laws about duty to warn.
What is false, each state tends to have their specific laws regarding duty to warn?
This 1976 court case involved a psychiatric patient who told their psychiatrists they intended to harm a young woman, and later murdered her.
What is Tarasoff v Regents of University of California?
Presumed Confidentiality: Why is confidentiality and patient trust so important/what are the potential ramifications for a breach of confidentiality by a provider?
1. Discourages patients from revealing information pertinent to diagnosis/treatment
2. Preserving patient autonomy over what information they want to keep private
3. Avoiding unforeseen harms such as revealing stigmatized health conditions
4. Federal and state laws mandating confidentiality (HIPAA)
During a sports physical, a 15-year-old patient mentions casually that her boyfriend is 22 years old. She insists the relationship is “completely safe and private” and asks you not to tell her parents or anyone else.
What should you do regarding confidentiality in this situation?
What is report the situation to the appropriate authorities.
These three conditions trigger the Duty to Protect for medical professionals for the state of Georgia.
What is a specific victim, a credible threat, and imminent danger?
This 1996 judicial case ruled that a provider had a duty to inform a patient's child/family of their increased genetic risk to a disease.
What is Safer v Pack?
What is the term we learned for providers obligation to report/discuss a diagnosis with a patient, despite their family’s insistence that they can't handle it or they wouldn’t understand?
Providers duty to warn
A 30-year-old male patient being treated for severe anxiety tells you during a follow-up visit, “My neighbor keeps parking in my spot. I swear, if he does it one more time, I’m going to make him regret it.” When you ask what he means, he replies, “Don’t worry about it — you’ll hear about it on the news" then laughs and changes the subject.
What should you do in this situation under your ethical and legal obligations?
What is you must take reasonable steps to protect the identifiable potential victim?
How is Georgia’s law regarding patient confidentiality different from federal HIPPA laws?
Georgia Code states “physicians, hospitals, or health-care facilities shall not be required to release any medical information except on written authorization or other waiver by the patient or on appropriate court order or subpoena.”
This 1969 court case involved a film made with the permission of inmates and prison officials that depicted the inmates as mentally unstable, nude, and in a degrading manner.
What is Commonwealth v Wiseman?
When in doubt about whether to release patient information, a Georgia PA should first do this before disclosing.
What is consult the supervising physician or risk management?